Prolonged Duration of Brain Death was Associated with Better Kidney Allograft Function and Survival: A Prospective Cohort Analysis

Autor: Luuk B. Hilbrands, Rogier Donders, Michiel C. Warlé, Mehmet Ergün, Andries J. Hoitsma, Denise M. D. Özdemir-van Brunschot
Rok vydání: 2019
Předmět:
Graft Rejection
Male
Brain Death
medicine.medical_specialty
Time Factors
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
030232 urology & nephrology
Delayed Graft Function
030204 cardiovascular system & hematology
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Prospective Studies
Prospective cohort study
Kidney transplantation
Survival analysis
Original Paper
Transplantation
Creatinine
Kidney
business.industry
Incidence
Incidence (epidemiology)
Graft Survival
Other Research Radboud Institute for Health Sciences [Radboudumc 0]
General Medicine
Middle Aged
Prognosis
medicine.disease
Kidney Transplantation
Survival Analysis
Tissue Donors
surgical procedures
operative
medicine.anatomical_structure
chemistry
Tissue and Organ Harvesting
Cardiology
Population study
Female
Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
business
Follow-Up Studies
Zdroj: Annals of Transplantation, 24, pp. 147-154
Annals of Transplantation, 24, 147-154
Annals of Transplantation
ISSN: 2329-0358
1425-9524
Popis: Contains fulltext : 205520.pdf (Publisher’s version ) (Open Access) BACKGROUND Brain death initiates hemodynamic, immunological, and hormonal changes that potentially compromise organ quality for transplantation. Therefore, it is generally believed that organs should be procured as soon as possible after the declaration of brain death. However, conflicting data exist regarding the impact of brain death duration on long-term graft function and survival. MATERIAL AND METHODS The effect of duration of brain death on graft survival and function of 1869 adult transplant recipients receiving kidneys from deceased donors after brain death was analyzed, using relevant donor and recipient characteristics and allograft related factors. RESULTS Duration of brain death was a significant predictor for long-term graft survival, whilst there was no significant effect of duration of brain death on the incidence of delayed graft function or acute graft rejection after kidney transplantation. After dividing the study population into a "short durBD" (10.6 hours) group, the 15-year graft survival estimates were significantly higher and the serum creatinine at 3 months after transplantation was significantly lower in the "long durBD" group. CONCLUSIONS Duration of brain death does not affect the incidence of delayed graft function or acute rejection after kidney transplantation. However, longer duration of brain death is associated with better kidney allograft function and survival.
Databáze: OpenAIRE
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